CVS Health

Remote/Telecommute

Case Management Coordinator - Winter Park, East Orlando FL

Posted over 1 month ago

Job Description

Job Description
Utilizes critical thinking and judgment to collaborate and inform the case management process, in order to facilitate appropriate healthcare outcomes for members by providing care coordination, support and education for members through the use of care management tools and resources.
Conducts comprehensive evaluation of Members using care management tools and information/data review.
Coordinates and implements assigned care plan activities and monitors care plan progress.
Conducts multidisciplinary review in order to achieve optimal outcomes.
Identifies and escalates quality of care issues through established channels.
Utilizes negotiation skills to secure appropriate options and services necessary to meet the members benefits and/or healthcare needs.
Utilizes influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.
Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
Helps member actively and knowledgeably participate with their provider in healthcare decision-making.

Monitoring, Evaluation and Documentation of Care:
Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.

Required Qualifications
701B Certification required (Department Elder Affairs)
Knowledge of Medicaid and Medicare required
Must have strong use of Microsoft office including Excel and ability to multitask
Travel required 50-75% in local and surrounding areas (Winter Park, East Orlando FL)

Preferred Qualifications
Case management and or discharge planning experience preferred.
2+ years experience in behavioral health, social services or appropriate related field equivalent to program focus preferred
Managed Care experience preferred
LTC (long term care) Case management experience preferred.
Experience in conducting home visits and service coordination preferred

Education
Bachelor's degree or non-licensed master level clinician required, with either degree being in behavioral health or human services preferred (psychology, social work, marriage and family therapy, counseling).
701B Certification required prior to starting
Person Centered Care Planning Certification preferred; required to obtain once hired.

Business Overview
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.


We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.

54903071

Sorry, this job has expired.